Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations

Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in d...

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Bibliographic Details
Published in:The journal of orthopaedic and sports physical therapy 2015-11, Vol.45 (11), p.887-898
Main Authors: Malliaras, Peter, Cook, Jill, Purdam, Craig, Rio, Ebonie
Format: Article
Language:English
Subjects:
Athletic Injuries - diagnosis
Athletic Injuries - rehabilitation
Biomechanical Phenomena
Diagnosis, Differential
Diagnostic Imaging
Humans
Pain Measurement
Patellar Ligament - injuries
Risk Factors
Tendinopathy - diagnosis
Tendinopathy - rehabilitation
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Summary:Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should focus on progressively developing load tolerance of the tendon, the musculoskeletal unit, and the kinetic chain, as well as addressing key biomechanical and other risk factors. Rehabilitation can be slow and sometimes frustrating. This review aims to assist clinicians with key concepts related to examination, diagnosis, and management of patellar tendinopathy. Difficult clinical presentations (eg, highly irritable tendon, systemic comorbidities) as well as common pitfalls, such as unrealistic rehabilitation time frames and overreliance on passive treatments, are also discussed. J Orthop Sports Phys Ther 2015;45(11):887-898. Epub 21 Sep 2015. doi:10.2519/jospt.2015.5987.
ISSN:0190-6011
1938-1344
DOI:10.2519/jospt.2015.5987